Authorization to Release PHI
Authorization to Use Email for Communications
HIPAA Privacy Notice
HIPAA Privacy Notice Signature Page
Client Registration Information
General Nutrition Assessment Questionnaire
Food Intake Log
Food Intake Log Instructions
Medical Clearance for Weight Loss Program
Southwest Dietetic Group, Inc. 201 Cedar St SE ~ Suite 505 ~ Albuquerque, NM 87106 Phone: 505-353-5226 Fax: 505-792-6956
Copyright © 2010 and beyond, Southwest Dietetic Group, Inc. All rights reserved.
